News that a four-year-old boy, Daniel Veres, drowned at the weekend in a swimming pool belonging to Pamela Anderson's ex-husband, Tommy Lee, will have given every parent pause for thought. Despite being surrounded by children playing in the water at five-year-old Brandon Lee's birthday party, with a nanny supervising and other adults watching, no one spotted the little boy struggling.

The fact that it happened in Malibu rather than Macclesfield makes no difference. It is the kind of accident that could happen to any child anywhere. According to reports, adults at the party attempted mouth to mouth resuscitation, to no avail. But ask yourself how well prepared you would be in the same situation?

According to the Child Accident Prevention Trust, around 1m children under 14 visit casualty every year after an accident at home. Of these, the majority - 580,023 in 1999 - are under four.

When accidents do happen, few parents know what to do. In a recent survey published in Mother and Baby magazine, parents were asked how they would save their child's life in a medical emergency. The results suggest that most of us are woefully ill-prepared; only a quarter of parents knew how to resuscitate, or dress a deep wound. Of the 30% of parents who had already been faced with a young child swallowing a chemical such as soap powder or bleach, an alarming 92% said they had not known what to do. Almost as many were ignorant about what to do in the case of convulsions, loss of consciousness or electric shock.

In the worst cases, without proper intervention, simple accidents can end in tragedy. Alicia Carey finds it difficult to talk about the death of her friend's child whom she witnessed choking to death at the dinner table.

"There were complications, but nevertheless the feeling of total horror and helplessness is not something you forget," she says. "It made me find out about first-aid courses, but it doesn't help me feeling that I wish I had known what to do at the time while the ambulance was on its way. The thought that you might have been able to do more..."

It was in response to what they saw as a dangerous lack of awareness about child medical emergencies that two mothers in north London set up Safe and Sound. Tina Lazarus, who has two young sons herself, explains: "First aid isn't rocket science: most of the time you're dealing with minor injuries and preventing them getting worse. But one of the most important things the trainers on our course teach is how to recognise a situation and to have a plan of action.

"It's fine to panic," she says. "If you didn't panic, it would be quite dangerous, but you need to get over that. It is a terrible situation to be paralysed by fear. Our course gives you the resources to take action."

Robert Jones has four small children. When he heard about Safe and Sound, he saw it as an opportunity to be better prepared."You never know if you're going to remember all those things in times of crisis but somehow they come back to the surface," he says. On one occasion, his son appeared with his mouth covered in blue children's paint; Jones took him straight to the poisons unit of the local hospital. "The course was a help," he says, "because it took the panic out of the situation through having a set of rules to follow."

It is not just parents who are on the front line in an emergency. Very few childminders, nannies, au pairs, grandparents and babysitters have had training to enable them to deal with a serious accident. Amanda Edwards, a childminder in Cheshire, had to cope with a serious situation only a week after a St John Ambulance "baby safe" course.

"I'd just completed the part about resuscitation and one morning I was preparing food when my neighbour came tearing round, screaming that her 18-month-old son had stopped breathing and his face had turned blue," she recalls.

Faced with a panic-stricken mother and a lifeless baby, she says: "I didn't have time to think - your brain just kicks in. I think if it had been my baby, I might have gone to pieces, but I just remembered what I had learned. I checked there was nothing in his mouth, tipped his head back to clear his airways and put my hand over his nose and breathed into his mouth. One breath was enough to get him breathing again. Then I put him in the recovery position until the ambulance arrived."

The paramedics said that if Amanda hadn't known what to do, it might have been difficult to revive the baby. It was only afterwards that the enormity of what Amanda had done, sank in. "Without the St John Ambulance course, I wouldn't have known what to do," she says. "I'm just so glad that I could help out."

Maggie Dyer has run the London Au Pair and Nanny agency for 22 years and says many parents are want the person looking after their children to have a first-aid qualification. "Until about two years ago, most never gave first aid a thought. But the the cases of Louise Woodward in the US and of Louise Sullivan, an Australian nanny convicted of killing a baby in her charge, have prompted parents to demand higher standards. Dyer says that reputable agencies will insist qualifications for staff that include first-aid training.

While regulations have tightened up at the top end of the market for parents who can afford an agency nanny, there is little provision further down the childcare ladder. The glut of enthusiastic young women, mainly from eastern Europe, who are working, or looking for jobs, as nannies and au pairs to UK parents are, on the whole, unqualified and without any knowledge of first aid.

But they can learn about it. "Safe and Sound was originally set up just for au pairs, many of whom have English as a second language," says Tina Lazarus. "Although they are not directly employed to care for children, a lot of the tasks they are asked to do, like picking them up from school, means that they spend a lot of time with the children. Some, we were horrified to learn, did not even know how to ring for emergency services and had been too embarrassed to ask the parents. We wanted to ensure in our training that everyone who attended could understand, so we use translators."

The British Red Cross also provides first-aid courses for childcarers, run on behalf of the National Childminding Association and Pre-School Learning Alliance, but these are quite expensive. A childminder would have to regard the certificate gained as an investment in her career to make it worthwhile. A more accessible, and cheaper, alternative is the Mother and Baby Save A Life campaign, run by St John Ambulance (at selected Tesco stores throughout the UK). They last three hours and cost £5: a small price to pay for a child's life.